• Bifidobacterium bifidum MIMBb75 in irritable bowel syndrome.

      Quigley, E M M (Blackwell Publishing Ltd., 2011-07)
    • Bilateral brachial neuropathy and acute aortic dissection due to giant cell arteritis.

      Saidha, S; Mok, T H; Butler, M; Keohane, C; Harrington, H (2009-08)
    • Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

      Leong, S; Oisin, F; Barry, J E; Maher, M M; Bogue, C O; Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland, leong81@gmail.com. (2010-06-19)
      BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.
    • Bilateral malignant ovarian haemangiopericytoma.

      Wong, V V; O'Brien, O; De Tavernier, M; Department of Gynaecology, Cork University Hospital, Wilton, Cork, Republic of Ireland. vuivunwong@yahoo.com (2011)
    • Bilateral spontaneous rupture of flexor digitorum profundus tendons.

      O'Sullivan, S T; Reardon, C M; O'Shaughnessy, M; Condon, K C; Department of Plastic Surgery, Cork University Hospital, Wilton, Ireland. (2012-02-03)
      Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.
    • Biological behaviour and clinical implications of micrometastases.

      Kell, M R; Winter, D C; O'Sullivan, G C; Shanahan, F; Redmond, H P; Departments of Academic Surgery and Medicine, National University of Ireland,, Cork University Hospital and Mercy Hospital, Cork, Ireland. (2012-02-03)
      BACKGROUND: The most important prognostic determinant in cancer is the identification of disseminated tumour burden (metastases). Micrometastases are microscopic (smaller than 2 mm) deposits of malignant cells that are segregated spatially from the primary tumour and depend on neovascular formation (angiogenesis) to propagate. METHODS: The electronic literature (1966 to present) on micrometastases and their implications in malignant melanoma and epithelial cancers was reviewed. RESULTS: Immunohistochemical techniques combined with serial sectioning offer the best accuracy for detection of nodal micrometastases. Molecular techniques should be reserved for blood samples or bone marrow aspirates. Detection of micrometastases in regional lymph nodes and/or bone marrow confers a poor prognosis in epithelial cancers. The concept of sentinel node biopsy combined with serial sectioning and dedicated screening for micrometastases may improve staging procedures. Strategies against angiogenesis may provide novel therapies to induce and maintain micrometastatic dormancy. CONCLUSION: The concept of micrometastases has resulted in a paradigm shift in the staging of epithelial tumours and our overall understanding of malignant processes.
    • The biomechanical evaluation of polyester as a tension band for the internal fixation of patellar fractures.

      McGreal, G; Reidy, D; Joy, A; Mahalingam, K; Cashman, W F; Cork University Hospital, Ireland. (2012-02-03)
      We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eight using braided polyester. All specimens were subjected to tensile testing. Polyester was 75.0% as strong as wire. For dynamic testing, the patellae of seven cadaveric knees were fractured and then fixed with polyester tension bands. These were mounted in a device capable of extending the knees from 90 degrees to neutral against an applied force. None of the fixations failed. Three of the specimens fixed using 18 gauge stainless steel wire were compared with three fixed using polyester over 2000 cycles of knee flexion and extension. Polyester performed as well as wire. We conclude that polyester is an acceptable alternative to wire in tension band fixation.
    • BIPAP- Too Little, Too Late?

      Oh, S; O’Carroll, G; Akintola, A; Byrne, D (Irish Medical Journal, 2014)
      Life-saving treatment for acute respiratory failure (ARF) traditionally mandated endotracheal intubation and positive pressure ventilation. However, this method of mechanical ventilatory assistance has its complications; hence the use of non-invasive ventilation (NIV) has emerged in recent times to become the preferred treatment modality 1 . The success of NIV depends on careful selection of patients who meet the well-established criteria for NIV and demonstrate no contraindications. Previous studies have shown that application of NIV on patients with an acute exacerbation of COPD may reduce the risk of intubation by almost 70% 2 .
    • Blurred vision as primary presentation of tuberculosis.

      O'Connor, Jeremy; Cullinane, Anthony; Department of Ophthalmology, Cork University Hospital, Ireland. jeremyoconnor_ie@yahoo.com (2011-08)
    • Body composition by computed tomography as a predictor of toxicity in patients with renal cell carcinoma treated with sunitinib.

      Cushen, Samantha J; Power, Derek G; Teo, Min Y; Maceneaney, Peter; Maher, Michael M; McDermott, Ray; O'Sullivan, Kathleen; Ryan, Aoife M; *Department of Food & Nutritional Sciences ∥School of Mathematical Science, University College Cork †Department of Medical Oncology, Mercy & Cork University Hospitals §Department of Radiology, Mercy University Hospital, Cork ‡Department Medical Oncology, Adelaide & Meath Hospital incorporating National Children's Hospital, Tallaght, Ireland. (2014-04-21)
      Sunitinib is a standard first-line option for metastatic renal cell carcinoma (mRCC). Body composition is a prognostic factor in cancer patients and patients with loss of skeletal muscle mass and fat-free mass (FFM) are prone to dose-limiting toxicity (DLT) during targeted drug therapy. We investigated whether body composition by computed tomography predicted DLT from sunitinib in mRCC.
    • Botulinum toxin for treatment of glandular hypersecretory disorders.

      Laing, T A; Laing, M E; O'Sullivan, S T; Department of Plastic and Reconstructive Surgery, Cork University Hospital, Cork,, Ireland. (2012-02-03)
      SUMMARY: The use of botulinum toxin to treat disorders of the salivary glands is increasing in popularity in recent years. Recent reports of the use of botulinum toxin in glandular hypersecretion suggest overall favourable results with minimal side-effects. However, few randomised clinical trials means that data are limited with respect to candidate suitability, treatment dosages, frequency and duration of treatment. We report a selection of such cases from our own department managed with botulinum toxin and review the current data on use of the toxin to treat salivary gland disorders such as Frey's syndrome, excessive salivation (sialorrhoea), focal and general hyperhidrosis, excessive lacrimation and chronic rhinitis.
    • Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient.

      Mc Laughlin, Patrick; Eustace, Joseph; Mc Sweeney, Sean; Mc Williams, Sebastian; O'Regan, Kevin; O'Connor, Michael; Kelly, Denis; Maher, Michael M; Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland. mclaughlin.paddy@gmail.com (2010-03)
      Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients.
    • Brachial neuritis masquerading as acute coronary syndrome.

      Dineen, J; Saidha, S; McNamara, B; Plant, B; Ryan, A M; Department of Neurology, National Neuroscience Centre, Cork University Hospital, Cork, Ireland. (2011-03)
      Brachial neuritis is a frequently misdiagnosed condition which can present to many medical or surgical specialties.
    • Brain-gut axis and mucosal immunity: a perspective on mucosal psychoneuroimmunology.

      Shanahan, F; Department of Medicine, National University of Ireland, and Cork University, Hospital. (2012-02-03)
      The role of the brain-gut axis has traditionally been investigated in relation to intestinal motility, secretion, and vascularity. More recently, the concept of brain-gut dialogue has extended to the relationship between the nervous system and mucosal immune function. There is compelling evidence for a reciprocal or bi-directional communication between the immune system and the neuroendocrine system. This is mediated, in part, by shared ligands (chemical messengers) and receptors that are common to the immune and nervous systems. Although the concept of psychoneuroimmunology and neuroimmune cross-talk has been studied primarily in the context of the systemic immune system, it is likely to have special significance in the gut. The mucosal immune system is anatomically, functionally, and operationally distinct from the systemic immune system and is subject to independent regulatory signals. Furthermore, the intestinal mucosal immune system operates in a local milieu that depends on a dense innervation for its integrity, with juxtaposition of neuroendocrine cells and mucosal immune cells. An overview of evidence for the biologic plausibility of a brain-gut-immune axis is presented and its potential relevance to mucosal inflammatory disorders is discussed.
    • Branch retinal artery occlusion following elective percutaneous coronary intervention.

      O'Connor, Jeremy; Kiernan, Thomas J; Department of Ophthalmology, Cork University Hospital, Cork, Ireland. jeremyoconnor_ie@yahoo.com (2011-04)
    • Breaking bad news--parents' experience of learning that their child has leukaemia.

      Oshea, J; Smith, O; O'Marcaigh, A; McMahon, C; Geoghegan, R; Cotter, M; Department of Paediatrics, Cork University Hospital, Cork. jemos2@yahoo.co.uk (2012-02-03)
      This study aimed to seek parents' experiences of how they learned their child had leukaemia and therefore identify ways of improving this process. To achieve this task a questionnaire was designed to ask parents about specific elements of the initial interview and give them opportunity to add their thoughts and feelings on the subject. All children with a diagnosis of leukaemia over an eighteen-year period were identified and parents of those children still alive were invited to partake in the study. 49 out of 50 families agreed to participate of which 35 (72%) returned completed questionnaires. The majority 29 (83%) expressed overall satisfaction. Their replies confirmed some findings of previous studies, and also offered some new insights. Examples of new findings or expansion on previous findings include observations on the presence of young children at the initial interview; the importance of the language used in conveying the diagnosis and prognostic information, and a preference for actuarial terms when discussing prognosis. Telling parents their child has leukaemia is a challenging and important task. The experience of parents gives us valuable insights into our own communication skills and highlights areas of possible improvement in this difficult area.
    • Brief reports: a clinical evaluation of block characteristics using one milliliter 2% lidocaine in ultrasound-guided axillary brachial plexus block.

      O'Donnell, Brian; Riordan, John; Ahmad, Ishtiaq; Iohom, Gabriella; Department of Anaesthesia, Cork University Hospital, Wilton Rd., Cork, Ireland. briodnl@gmail.co (2010-09)
      We report onset and duration of ultrasound-guided axillary brachial plexus block using 1 mL of 2% lidocaine with 1:200,000 epinephrine per nerve (total local anesthetic volume 4 mL). Block performance time, block onset time, duration of surgery, and block duration were measured. Seventeen consecutive patients were recruited. The mean (SD) block performance and onset times were 271 (67.9) seconds and 9.7 (3.7) minutes, respectively. Block duration was 160.8 (30.7) minutes. All operations were performed using regional anesthesia alone. The duration of anesthesia obtained is sufficient for most ambulatory hand surgery.
    • Bronchogenic adenocarcinoma presenting as a synchronous solitary lytic skull lesion with ischaemic stroke--case report and literature review.

      O'Connell, David; Kaliaperumal, Chandrasekaran; Wyse, Gerald; McCarthy, Julie; Ryan, Aisling; Department of Neurosurgery, Cork University Hospital, Cork, Ireland. (2011)
      The authors describe a rare case of metastatic bronchogenic adenocarcinoma in a 55-year-old man presenting with concomittant solitary lytic skull lesion and ischaemic stroke. Metastatic bronchogenic carcinoma is known to present as lytic skull lesions. Primary brain tumours are also known to cause ischaemic brain injury. An underlying stroke risk may be exagerated by cranial tumour surgery. Patients with brain tumours are well known to be predisposed to an increased risk of developing thromboembolic disease. It is unusual to see metastatic bronchogenic adenocarcinoma presenting as ischaemic stroke with a background of concomittant cerebral metastasis. The aetio-pathogenesis of this rare occurrence is discussed with a review of literature.
    • Bugs on the brain; brain in the gut--seeking explanations for common gastrointestinal symptoms.

      Quigley, E M M; Department of Medicine, Alimentary Pharmbiotic Centre, University College Cork, Cork University Hospital, Clinical Sciences Building, Cork, Ireland. e.quigley@ucc.ie (2013-03)
      Gastrointestinal symptoms such as heartburn, indigestion (or dyspepsia), bloating, distension, constipation, abdominal pain, abdominal discomfort and diarrhoea are extremely common worldwide. For some, such symptoms can prove to be chronic and disabling.